VIGNETTE

Laura, Gary, Bridget, Chris and Theresa have been referred to social services. Laura is an 83-year-old White British lesbian. Her civil partner died last year and she now lives alone in their large multi-storey house in a rural area. She has several private pensions. Her eyesight is deteriorating and she can no longer drive. She is lonely and depressed. Gary is a single 70-year-old gay man of African Caribbean decent, living in an inner-city local authority flat and reliant on state pensions and other forms of welfare support. He is showing signs of memory loss and confusion. Bridget is a 65-year-old bi-identifying woman of White Irish Catholic origin. She lives in the suburbs with her partner, Chris, aged 69, a White British bisexual man who has multiple sclerosis, needing increasing care and support. Their daughter is supportive, but lives a long distance away. Theresa is a 61-year-old heterosexual trans woman with an Asian/White British heritage, who transitioned three years ago. She has a son, but they are estranged. She lives in a sheltered housing scheme for people with mental health issues. Theresa has complained that staff are discriminating against her.

What would good practice look like for each of these people?

Introduction

Lesbian, gay, bisexual and trans (LGBT) ageing occurs in wide-ranging socio-legal contexts. In countries where there is a lack of legal recognition and social protections, the health of LGBT people is impacted not only by the accumulated effects of discrimination but also by the fact that their older age care needs are served by health and social care systems that offer little or no recognition of their minority identities (AGE Platform Europe and ILGA-Europe, 2012). Even in more liberal countries offering some forms of legal rights, older LGBT people experience a range of health inequalities (Fish, 2007). These disadvantages (Fredriksen-Goldsen et al, 2013a, 2013b) can be clustered into four main areas:

• • the cumulative physical and psychological effects of discrimination, stigma and marginalisation across the lifecourse;

• • a relative lack of social capital, particularly informal social support, compared with heterosexual and cisgender older people;

• • health and social care provision that is ill-equipped to recognise and meet the needs of older LGBT people (Fish, 2007; 2009);